Knowledge Integration in Quitlines: Networks that Improve Cessation (KIQ NIC) Abstract One in every five deaths in the U.S. is related to tobacco use, and it remains the leading preventable cause of premature death. Given the highly complex nature of tobacco use as a public health threat, the National Cancer Institute supported an initiative and a recently published tobacco control monograph designed to describe in what ways (systems thinking) might improve tobacco control efforts. In that monograph, NCI identified social network analysis and factors related to communication between individuals and groups as critical to understanding and improving the dissemination and implementation of best practices within organizations that are part of a complex adaptive system such as tobacco control (NCI, 2007). This investigative team was central to the NCI initiative and Monograph, and the proposed study is a direct extension of that initiative. The proposed study is designed to better understand the network and communications mechanisms by which stakeholders in an existing and well-defined tobacco control network } the North American Quitline Consortium (NAQC) } interact, share new evidence, make decisions on how and when to implement new knowledge, and actually adopt practices that they believe will improve quitline outcomes. The NAQC is funded by NCI, CDC and other organizations as a unique research-to-practice collaboration to support telephone- based tobacco cessation. As of 2006, every U. S. state (including D.C.) and every Canadian province had implemented a smoking cessation quitline, thus resulting in a population of 62 quitlines that will be included in the proposed study. Following a formative year of instrument development and team building between the researchers and NAQC members, three waves of social network and decision-making analyses will be implemented to analyze processes of adoption and implementation of new evidence and knowledge. In addition, actual quitline operations will be analyzed in order to track implementation of new practices, and multivariate modeling will assess the relative influences of network, decision-making, and other potential influences on adoption of new quitline practices. The results are expected to increase our understanding of how to bridge the gaps between researchers, services organizations, providers, and clients, and to explore how new knowledge} especially new scientific evidence} is disseminated, implemented, and integrated within the NAQC. PUBLIC HEALTH RELEVANCE: One in every five deaths in the U.S. is related to tobacco use, and it remains the leading preventable cause of premature death. Fortunately, every state and Province in the U.S. and Canada, respectively, now has a free telephone quitline to help smokers quit. Unfortunately, we know little about how best practices and innovations are implemented in those quitlines. The proposed study is designed to better understand how the network of quitlines implements best practices and innovations. Three waves of social network and decision-making analyses will be implemented to analyze processes of adoption and implementation of new evidence and knowledge, and actual quitline operations will be analyzed in order to track implementation of new practices.